MOH Completes 'House-to-House' Polio Vaccination Exercise - Liberian Daily Observer
MOH Completes 'House-to-House' Polio Vaccination Exercise - Liberian Daily Observer |
- MOH Completes 'House-to-House' Polio Vaccination Exercise - Liberian Daily Observer
- At this point, COVID-19 is a preventable disease -- even as thousands continue to get infected every day - MLive.com
- Op-Ed: Why Redfield Is Wrong on SARS-CoV-2 Origins - MedPage Today
| MOH Completes 'House-to-House' Polio Vaccination Exercise - Liberian Daily Observer Posted: 05 Apr 2021 12:00 AM PDT  The Ministry of Health and Social Welfare (MHSW) with support from the Global Polio Eradication Initiative (GPEI), has recently completed a four-day polio vaccination exercise across Liberia. According to a press release, the ministry targeted to vaccinate 972,870 children under the age of five. The vaccination exercise started on Friday, March 26, and ended on Monday, March 29. Polio is a highly infectious disease that is spread in places with poor sanitation, open defecation, and overcrowding that affects mostly children. The virus has no cure, and it causes lifelong paralysis in children, and in some cases, can cause death, experts report. The virus is also transmitted when water, food, or hands become contaminated by stool containing weaker diseases. The exercise, according to the release, was in collaboration with partners. The release further added that the goal of the exercise was to vaccinate 95% of the 972,870 targeted while observing COVID-19 protocols that ensure vaccinators, health workers, and communities adhere to the pandemic precaution. GPEI which includes the World Health Organization (WHO), UNICEF, the Vaccine Alliance (GAVI), Center for Disease (CDC) and Rotary goal is to ensure that no child is ever paralyzed again by the virus. It can be recalled in February 2021, the MOH declared Polio as an outbreak in the country as a public health emergency. The polio outbreak was the country's first since 2008. "Children in Liberia are at a risk of contracting this incurable disease if they are not vaccinated against polio," the Ministry says. A child cannot get the Vaccine-Deprived Poliovirus (cVDPV) infection after receiving a vaccine. cVDPVs emerge when not enough children are vaccinated against polio, and the weakened strain of the poliovirus contained in the oral polio vaccine (OPV) circulates among under-immunized populations for a long time in areas with poor sanitary conditions. This according to the MOH, is in line with the world's efforts to curb and eradicate the Polio virus. The ministry is therefore encouraging citizens and residents in the borders of Liberia to make available their children under the age of 5 to be vaccinated. Many times parents and guardians denied the children from taking vaccines due to fear that health workers may give different vaccines that will harm their children. However, the MOH has said that the vaccine has little to no side effects and can be given multiple times to boost immunity against the virus. Additionally, the vaccine, according to the Polio Global Eradication Initiative (PGEI), is very safe and interrupts the person-to-person spread of polio. However, on rare occasions, in under-immunized populations, the live weakened virus originally contained in OPV can mutate into cVDPV. As the world gets closer to ending the transmission of wild polio altogether, the global polio program will increasingly focus on eliminating the risk of cVDPV.  |
| Posted: 24 Apr 2021 06:31 AM PDT  A year ago when Michigan was being ravaged by COVID-19, the big problem was a novel virus that had no vaccine and no effective treatments, and scientists were still trying to figure out exactly how the virus was transmitted. Today, Michigan is being ravaged in a surge that's even worse than a year ago. But there's some big difference this time: Vaccines are now available and we know the strategies that best stymie transmission. "It really is mostly a preventable disease," said Dr. Joel Fishbain, an infectious disease specialist for Beaumont Hospital Grosse Pointe. So the fact that Michigan emergency departments and COVID-19 inpatient units are overflowing with patients is a huge source of frustration for many health professionals, who say we now have the tools to end the pandemic. The big missing piece at this point: Widespread public cooperation, both in getting all adults vaccinated as soon as possible and in following mitigation strategies, such as masking and avoiding large gatherings, until that happens. "The good news is that we have enough science at this point" to know what works, Fishbain said. "I don't want to get involved with the politics of it, but individuals really can prevent the spread of this. ... It is frustrating for us to keep seeing people sick with COVID who have not been vaccinated and certainly could be." Still, he said, "we're not going to shame people. That's not the way to go about it. It's not about shaming and refusal; it's about individual decision-making. But the more people who get (the vaccine), the better off everybody's going to be." Vaccinations are key The most important step that individuals can take: If you haven't already, get vaccinated ASAP. "The vaccines have been wildly successful" at preventing hospitalizations and deaths, and they also appear to significantly reduce transmission of COVID-19, although more data is needed on the latter, said Dr. Liam Sullivan, infectious disease specialist for Spectrum Health in Grand Rapids. The vaccines' effectiveness is evident in the huge, dramatic drop in cases in Michigan's nursing homes and prisons, the two hardest-hit settings in 2020. Michigan's long-term care facilities currently are averaging 15 new COVID-19 cases a day compared to 192 at the height of the fall surge, even as current case numbers are matching fall levels in the general public. Meanwhile, Michigan's prison system -- where 60% of inmates have agreed to be vaccinated to date -- is now averaging three new cases a day compared to 361 during the first week of December. And the seven-day average positivity rate on coronavirus diagnostic tests has dropped to 0.4% for the corrections system, a stark contrast to the 13.4% statewide average. Vaccinations serve multiple purposes, doctors say. They not only protect the individual but also the people around him or her. The more people who get vaccinated, the fewer opportunities for the virus to spread. If and when enough people are inoculated, the virus could fizzle out -- which is what happened to once-common diseases such as measles and polio. Vaccines also limit the development and spread of COVID-19 variants. Fastest path to ending the pandemic? Vaccinations, doctor say. Sullivan noted there's never been a contagious disease that's been eliminated through natural immunity. He pointed to smallpox and measles as examples, saying there were regular epidemics of both for centuries until mandatory vaccines were implemented for each. (The ability of health officials to mandate vaccines was upheld by the U.S. Supreme Court in a 1905 landmark case, Jacobson vs. Massachusetts.) "We're not going to achieve herd immunity with COVID-19 by natural infection," Sullivan said. "It's not going to happen. It's a pipe dream and people need to realize that's a pipe dream. The only way we're going to get to herd immunity is through vaccination." Other mitigation strategies still needed That said, vaccinations have their limits. While they significantly reduce risk, they don't eliminate it, and Michigan has reported about 400 "break-though" cases of COVID-19 among the 1.8 million residents who are two weeks past their final vaccine dose. In addition, it takes about five to six weeks from the time that someone gets their first shot of the Pfizer or Moderna vaccine until they are considered fully immunized. For the Johnson & Johnson shot, the process takes about two weeks. That means less than a fifth of Michigan's population is considered fully immunized now, which is far below herd immunity. That helps explains why Michigan is seeing a current surge in cases even as thousands more people get vaccinated each day. But coronavirus is largely preventable even for people who are unvaccinated if they follow the protocols strongly advised for the past year -- wearing a mask, social distancing, avoiding large gatherings, especially if they're indoors, Fishbain said. "Vaccines are a great place to start, but everybody still needs to continue doing the basics -- do not congregate, wear masks, avoid gatherings, etc. etc.," he said. The science around the value of masking to prevent COVID-19 transmission has gotten stronger over the past year, experts say. And not only does masking reduce the risk of catching coronavirus, but masks also appear to reduce the severity of the disease if an individual is infected, since the person is inhaling less of the virus. "They're finding out there is direct correlation between viral load and disease severity," Entler said. That's especially significant now as the B.1.1.7. variant has become much more prevalent in Michigan, and that variant is both more contagious and more lethal. That variant is a big reason that Michigan's current surge is so problematic. Even as the proportion of coronavirus cases has dropped among senior citizens, thanks to vaccinations, there's been a spike in hospitalizations among younger adults who were much less likely to become severely ill during the first year of the pandemic. "It's like, you take what we were seeing before and shift it down by one or two decades," Fishbain said. "We've got 20-year-olds who are getting admitted, and 30-year-olds requiring oxygen, which we never saw before, and needing as much treatment as we can give them. We've got 40- and 50-year-olds ending up on ventilators." Getting public buy-in Even for people not at risk for serious illness, there are a surprising number who experience "long COVID," where patient's have symptoms that linger for weeks or months. While most COVID patients under age 50 "don't get severely ill, there are a growing number of people have have long-haul COVID symptoms," Sullivan said. "They have problems with smelling, with taste, with concentration, with memory, with fatigue, with night sweats. "So even though they had a mild illness the first time around, they're still dealing with these things month and months later, and that's not something you want to deal with when you're 25 or 35," he said. "Of course, you don't want to deal with it at any age, but especially when you're in the prime of your life." For that reason, prevention is the best strategy when it comes to COVID-19, and that starts with the vaccination, Sullivan said. And when it comes to weighing potential risks of the vaccines vs. risks of getting COVID, "it's a no-brainer," he said. The challenge at this point, he said, is "convincing the fence sitters" -- those who aren't opposed to vaccines in general but are hesitant about COVID vaccines because they are so new. "Probably the best way to get people who are hesitant to get vaccinated is to have their friends and family members who are vaccinated talk to them about it -- talk about why it's important and their own experience with the vaccine," Sullivan said. "I think they're probably in the best position to convince the fence sitters." Entler said it benefits everybody to get as many people vaccinated as fast as possible. "I wholeheartedly believe the longer it takes to get enough people vaccinated to get to herd immunity, the longer we're going to be in this pandemic," he said. Fishbain said that he understands the hesitation about COVID vaccine. "Is it frustrating? Yes. But do I understand it? Of course," he said. "Have we ever produced the vaccine in six months and released it to the public? No. Have we ever used a messenger RNA vaccine for vaccination? No. Do we have a history of releasing vaccines too early with complications? Yes." That said, "if you don't get vaccinated, realize that you're highly susceptible to catching the virus, which means you need to do what you're supposed to do to protect yourself from getting infected" -- such as masking and avoiding large gatherings, he said. Fishbain said he's frustrated by people who refuse to take precautions such as masking but also refuse to be vaccinated. "You can't have it both ways," he said. "Obviously, we have our individual freedoms and we have our autonomy where we get to make our own choices. But try to make the right choices." More on MLive: Michigan high schools look to build on lessons as prep sports enter widespread testing for spring What to do, and not do, with your COVID-19 vaccine card Delayed care and surge in coronavirus cases overwhelms Michigan hospitals for a third round  |
| Op-Ed: Why Redfield Is Wrong on SARS-CoV-2 Origins - MedPage Today Posted: 05 Apr 2021 12:00 AM PDT  Recent comments by former CDC Director Robert Redfield, MD, on CNN have helped push the question of the origins of SARS-CoV-2, the virus that causes COVID-19, back to the forefront of public discussion. Two theories have emerged: one, favored by most virologists, is that SARS-CoV-2 was transmitted in the wild from an animal – a bat or intermediate host species – to a person before exploding in Wuhan. The other, pushed by a vocal minority, holds that the virus was being secretly researched at the Wuhan Institute of Virology, a major research center, before escaping the lab through the accidental infection of a lab worker. Right now, we still don't know enough to be certain which route the virus took from its natural host to humans, though there are compelling reasons to believe the first scenario is far more probable. Redfield is suggesting more than an accidental version of the latter scenario though – he's saying that human action made SARS-CoV-2 the virus that it is. Unfortunately, Redfield's comments don't advance the discussion of SARS-CoV-2 origins, as they are unrooted in any evidence (by his own admission) and plagued by an apparent faulty understanding of basic virology. Broadly speaking, Redfield finds it implausible for a virus to jump from a bat to humans and immediately be as contagious as SARS-CoV-2. Rather, he thinks the virus was manipulated in the lab through a process called serial passage and became better adapted for human transmission. It's often stated almost as a truism, and apparently accepted by Redfield, that a virus crossing from animals into people has to undergo rapid adaptation to become transmissible in humans. While that may often be true, it doesn't have to be. We know SARS-CoV-2 itself can jump seamlessly between hosts – it's gone multiple times from humans into minks and spread like wildfire. It transmits perfectly well among hamsters and ferrets in the lab. If a human virus can transmit among mink, there's no basis to assume a bat virus can't transmit among humans. Us humans may think we're very special – but to a virus we are just another mammalian host. That said, it's undoubtedly true that any virus finding itself in a new host will adapt to new surroundings, and SARS-CoV-2 is no different. And maybe Redfield is right that this is an instance in which the virus circulating in animals wouldn't have been immediately efficient at human-to-human transmission. In that case, the virus would have to adapt quickly in humans and it would have had to do so before it was discovered by Chinese scientists in late December 2019. Did it have the chance then? A powerful recent study in Science estimated that SARS-CoV-2 first started circulating in Wuhan between mid-October and mid-November 2019, one or two months for it to circulate at a low level and adapt to a new host – us. But did it adapt? Another recent study, not yet peer-reviewed, identified a single mutation in the SARS-CoV-2 spike gene that probably occurred in those one to two months. These seemingly missing evolutionary links that led Redfield down the road to a lab accident are being filled by real scientific data in front of our eyes. Redfield's more sinister claim – that Chinese researchers passaged this virus repeatedly to make it grow better and thus adapted it to human transmission in the lab – simply doesn't hold up. A study from late 2020 in PLoS Biology demonstrated that the ability of SARS-related coronavirus spike proteins to bind to human cells is naturally evolving in the viral milieu, and a more recent not-yet-peer reviewed study found that SARS-CoV-2 isn't even unusually good at doing so; the spike of a closely related virus found in pangolins initiates infection of human cells much more effectively. SARS-CoV-2 is still adapting though. The spike protein from the B.1.1.7 variant acts a lot more like the pangolin virus spike protein. Evolution never stops. More fundamentally, adaptation to human transmission and virulence is exactly the opposite of what we'd expect from serial passage in cells or animals. This exact process is a classic way of weakening a virus to make a vaccine – the oral polio vaccine developed by Sabin and the yellow fever vaccine have used this approach, among many others. That's because viruses evolve virulence and transmission in a complex host system. If you extract them from that system and force them to evolve in a different context (like in cells outside a body) they "de-adapt" to the "real world," precisely the opposite of what Redfield suggests. Frankly, it's hard to understand why he wouldn't know that. Zooming out a bit, Redfield's comments landed just before the World Health Organization (WHO) SARS-CoV-2 origins report that designated a lab-release origin of the pandemic as "extremely unlikely." Extremely unlikely is a long way from impossible, and WHO Director-General Tedros Adhanom Ghebreyesus, MD, appropriately, in my view, urged the undertaking of a more comprehensive examination of this possibility. It is possible that a worker, in the course of say, attempting to grow a new virus from an animal sample, became infected and transmitted the infection. There are ample reasons, however, that most scientists view this as the less likely scenario. The biggest reason, exhaustively detailed in the WHO report, is that the intensity of infection surrounding the Huanan wildlife market and other animal markets in Wuhan in December 2019 is simply staggering. Amazingly though, if one looks at the landscape of human interaction with bat coronaviruses in China (and the closest viruses to SARS-CoV-2 are all from bats), it's amazing we've made it this far without a pandemic emerging from the wildlife trade. A 2018 study in Virologica Sinica found that 2.7% of people living near bat caves in southern China tested positive for prior infection with a SARS-related coronavirus, suggesting millions of infections that don't turn into anything. A step closer to the markets, a 2003 study conducted by the WHO and Chinese CDC found that 13% of animal traders tested positive for previous infection. It shouldn't be any surprise to have a contagion erupt from within this viral milieu. The surprise is that it doesn't happen more often. Questions are undoubtedly going to persist about the origin of SARS-CoV-2 until, and if, a definitive answer is uncovered (and perhaps beyond). Until then, it's imperative that leaders in science, public health, and government continue to call for rigorous study and stick to the science of viral evolution and viral ecology in their public commentary. One of the fundamental principles of a life in science is to admit what you don't know, and never be afraid to look it up. That's where Redfield falls short, unfortunately on a big stage. Stephen Goldstein, PhD, is a postdoctoral research associate at the University of Utah, studying viral evolution and genomics. Previously, he received his PhD from the University of Pennsylvania, where he studied MERS-CoV and its interactions with the host immune response.  |
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